First of all, dental treatment in the hospital can be reimbursed by the medical insurance.
Secondly, in the dental hospital reimbursement for medical treatment, fillings, extractions, treatment of gum disease can enjoy medical insurance reimbursement. Finally, the medical insurance designated dental hospital, you can use the medical insurance card for medical treatment. Participants can take their medical insurance cards to the designated medical institutions in the insured area to register and go to the dental department to see a dentist. The medical expenses incurred for dental fillings are covered by the medical insurance fund and can be paid directly with the medical insurance card. However, dental veneers and dental implants belong to the scope of medical cosmetic treatment, which cannot be paid by medical insurance card and need to be paid in cash. The medical insurance card can be reimbursed for the cost of visiting the dentist, but the reimbursement of dental expenses is subject to strict regulations, and only therapeutic dental treatment can be reimbursed by the medical insurance, such as fillings, extractions, and the treatment of periodontal disease, gingivitis, and other dental disease costs.
The medical insurance card (MIC) is a special card for the individual account of the medical insurance, which takes the personal ID card as the identification code, and stores detailed information such as the personal ID number, name, gender, and the allocation of the account funds, and the consumption situation. The card is issued by a designated local agent bank and is a type of multifunctional bank debit card.
The basic medical costs of hospitalization for employees enrolled in the comprehensive medical insurance shall be paid 90% by the basic medical insurance fund and 10% by the individual;
Retirees enrolled in the comprehensive medical insurance shall have 95% of the basic medical costs of hospitalization paid by the basic medical insurance fund and 5% by the individual, unless otherwise stipulated in the present Measures.
The outpatient basic medical expenses of the comprehensive medical insurance participants and the outpatient expenses for the drugs and diagnostic and therapeutic items in the local supplementary medical insurance drug list are paid by the individual account; if the individual account is insufficient to pay the outpatient basic medical expenses exceeding more than 10% of the average annual salary of the urban workers of the previous city year during the medical insurance year, 70% of the outpatient basic medical expenses shall be paid by the basic medical insurance fund and 30% shall be paid by the individual. The individual pays 30%.
To sum up, when a participant of comprehensive medical insurance undergoes large-scale medical equipment examination or treatment on an outpatient basis due to the need of his/her medical condition and approved by the municipal social insurance institution or the medical institution authorized by the municipal social insurance institution, his/her expenses will be paid by the basic medical insurance fund at a rate of 80%, and the individual will pay 20% out of his/her own pocket. The items of large-scale medical equipment examination and treatment shall be determined by the municipal social insurance institution.
Legal basis:
Article 28 of the Social Insurance Law of the People's Republic of China
Medical expenses that are in line with the drug list, diagnostic and therapeutic items, and standards of medical service facilities of the basic medical insurance as well as those of the emergency and rescue shall be paid out of the basic medical insurance fund in accordance with the state regulations.
Article 29
The portion of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units. The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.